June 13, 2012

Operating Rooms Draw Fire

Did you know that “fear of hospitals” is an actual medical condition? It’s called “nosocomephobia.” Richard Nixon had it, they think. (After refusing to get a treatment for a blood clot in 1974, he said, “if I go into the hospital, I'll never come out alive.”) I know what you’re thinking – Richard Nixon was a well-know paranoid. But as Joseph Heller put it in Catch 22, “Just because you're paranoid doesn't mean they aren't after you.” In fact, if you’re nosocomephobic, stop reading now because this story might really set you over the edge.

Yesterday, the FDA felt the need to hold a webinar called, “Practical Advice for Preventing Surgical Fires--Safety Strategies from the Front Lines,” to try to stop the “estimated 550 to 650 surgical fires per year in operating rooms in the U.S.” Yes, hundreds of people are catching fire in operating rooms each year. Reporter Aisling Swift for the Naples News had a truly unnerving story about this problem over the weekend. Here are a few key excerpts:

Frank Komorowski of East Naples was lying in a Naples operating room, under the sleepy twilight of anesthesia, when he heard a nurse yelling.

"Oh, my God! He's on fire!" Komorowski testified, recounting her screams, in his deposition. "And the next thing I remember is … smelling my skin burning."

Komorowski, then 68, suffered second-degree burns to his shoulder, chest and neck, and his hair was singed after he underwent surgery on March 19, 2008, to insert a pacemaker at NCH Downtown Naples Hospital.…

"The bottom line is they set the man on fire," Komorowski's attorney, Mark Weinstein of Weston, argued during a Collier Circuit Court hearing last week. "It is universally acknowledged this does not happen in the absence of negligence."

The cause apparently had something to do with an alcohol-based antiseptic, DuraPrep, which “caused an electrical cauterizing device to ignite.” The hospital tried to weasel out of responsibility, of course, pointing the finger at the surgeon who conveniently wasn’t a hospital employee. (Let’s hope they took that FDA webinar and learned something.) Fortunately, the judge didn’t agree, finding “adequate evidence to prove the hospital was liable no matter what caused it.”

Usually, oxygen is blame for these fires, writes the Naples News. For example:

In November, a 29-year-old Florida woman was having surgery to remove three cysts on her head when her face erupted in flames at an Okaloosa County hospital. The cauterizing tool erupted in flames after being fueled by her oxygen mask.

In June 2011, a surgeon was performing a tracheotomy at a New York hospital when his electronic scalpel, which sparks, set off the oxygen supply and prompted a minor explosion that caused severe burns on a 52-year-old patient's neck and chest.

In May 2011, a Pennsylvania jury found a nurse anesthetist negligent and liable for $250,000 in damages for injuries to a 72-year-old woman who suffered second-degree burns to her face and chest, and burns to her larynx, trachea and lungs, in September 2006. Testimony showed he administered extra oxygen but didn't tell the surgeon, who activated an electrocautery device that ignited the surgical drapes and prompted a flash fire at a Pennsylvania hospital.

An alcohol-based antiseptic that wasn't given time to dry caused 72-year-old Catherine Reuter to suffer second- and third-degree burns to her upper airway, chest, throat, face, and ear, during a tracheal operation in Washington, D.C., in December 2002. She was sedated for seven weeks due to pain and suffered multiple infections until she died two years later, never returning home. Her story and photos are featured on her daughter's site, surgicalfire.org, which she created to raise awareness.

"Every time I hear these stories, it breaks my heart because they are 100 percent preventable," Catherine Reuter Lake of Maryland told the Daily News. "I'm not out there to demonize hospitals, but they need to be held accountable.

"I was so horrified over the last images I had of my mom," she said, adding that the retired kindergarten teacher wasn't angry, but wanted her daughter to raise awareness. "She said they just weren't educated ... She said if it could happen to me, it could happen to other people ... That's the only thing you can do for me so more don't suffer."

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